Myocardial stretch in early systole is a key determinant of the synchrony of left ventricular mechanical activity in vivo
| Autor: | Makoto Amaki, Luis R. Scott, Gianni Pedrizzetti, Haruhiko Abe, Ayumi Nakabo, Giuseppe Caracciolo, Partho P. Sengupta, Georg Goliasch, Manish Bansal, Luka Lipar, Jagat Narula |
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| Přispěvatelé: | Giuseppe, Caracciolo, Georg, Goliasch, Makoto, Amaki, Manish, Bansal, Ayumi, Nakabo, Haruhiko, Abe, Luis, Scott, Luka, Lipar, Pedrizzetti, Gianni, Jagat, Narula, Partho P., Sengupta |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Contraction (grammar) Time Factors Systole medicine.medical_treatment Heart Ventricles Cardiac resynchronization therapy cardiac mechanics Ventricular Function Left Cardiac Resynchronization Therapy QRS complex In vivo Internal medicine medicine Humans Ventricular remodeling Aged Aged 80 and over Heart Failure Ventricular Remodeling business.industry Area under the curve General Medicine Middle Aged medicine.disease Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 77(10) |
| ISSN: | 1347-4820 |
| Popis: | BACKGROUND: Recent in-vitro observations suggest that left ventricular (LV) contraction is powered by 'stretch activation', an intrinsic mechanism by which the stretching of an activated cardiomyocyte causes delayed force redevelopment. We hypothesized that mechanical dyssynchrony is related to prolonged early systolic stretch that delays the timing of peak segmental shortening. METHODS AND RESULTS: The time intervals from R wave to segmental longitudinal stretch in early systole (Tstretch) and peak shortening (Tpeak) and the respective standard deviations (σTstretch and σTpeak) were measured by speckle-tracking echocardiography in 57 patients undergoing cardiac resynchronization therapy (CRT). The percentage of time spent in shortening, normalized to Tpeak duration [corrected ΔT=(Tpeak-Tstretch)/Tpeak] correlated with LV reverse remodeling (reduction in end-systolic volume ≥ 15%). Of the 57 patients, 40 (70.2%) demonstrated LV reverse remodeling at an average follow-up of 263 ± 125 days after CRT. At baseline, Tstretch and σTstretch correlated with Tpeak and σTpeak, respectively. Though there was no difference in Tstretch, Tpeak, σTstretch and σTpeak between responders and non-responders, corrected ΔT in the mid-lateral and mid-septal segments was shorter in the responders (P |
| Databáze: | OpenAIRE |
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